
<div class="layuimini-container">
    <form id="app-form" class="layui-form layuimini-form">
    <div class="layui-form-item">
        <label class="layui-form-label">客户名称：</label>
        <div class="layui-input-inline">
            <input type="text" name="name" lay-verify="required" lay-reqtext="客户名称不能为空" placeholder="请输入客户名称"
                value="" class="layui-input field-name">
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">联系手机：</label>
        <div class="layui-input-inline">
            <input type="text" name="mobile" placeholder="请输入联系手机" value="" class="layui-input field-mobile">
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">客户级别：</label>
        <div class="layui-input-inline">
			<select name="level_id" class="field-level_id">
				<option value="">请选择级别</option>
				{volist name="levelList" id="name" key="id"}
				<option value="{$id}">{$name}</option>
				{/volist}
			</select>
		</div>
    </div>
	<div class="layui-form-item">
        <label class="layui-form-label">客户行业：</label>
        <div class="layui-input-inline">
			<select name="industry_id" class="field-industry_id">
				<option value="">请选择行业</option>
				{volist name="industryList" id="name" key="id"}
				<option value="{$id}">{$name}</option>
				{/volist}
			</select>
		</div>
    </div>
	<div class="layui-form-item">
        <label class="layui-form-label">客户来源：</label>
        <div class="layui-input-inline">
			<select name="source_id" class="field-source_id">
				<option value="">请选择来源</option>
				{volist name="sourceList" id="name" key="id"}
				<option value="{$id}">{$name}</option>
				{/volist}
			</select>
		</div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">下次跟进时间：</label>
        <div class="layui-input-inline">
            <input type="text" name="next_time" class="layui-input field-next_time" data-date>
        </div>
		<div class="layui-form-mid layui-word-aux">日期面板左下角可选择跟进具体时间</div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">备注：</label>
        <div class="layui-input-block">
		  <textarea name="remark" placeholder="请输入内容" class="layui-textarea field-remark"></textarea>
		</div>
    </div>
    <input type="hidden" class="field-id" name="id">
    <div class="layui-form-item">
        <div class="layui-input-block">
            <button class="layui-btn layui-btn-normal" lay-submit lay-filter="saveBtn">确认保存</button>
            <button type="reset" class="layui-btn layui-btn-primary">重置</button>
        </div>
    </div>
    </form>
</div>

<script>
    // 扩展模块  config的设置是全局的
    layui.config({
        base: '/static/crm/js/modules/' //假设这是你存放拓展模块的根目录
    });

    layui.use(['form','jquery', 'layer', 'func'], function () {
        var form = layui.form,
            layer = layui.layer,
            $ = layui.jquery;

        layui.func.assign({:json_encode($data)});   // 解析数据
    });
</script>
</body>
</html>